Cosmetic Surgery Specialists Of Memphis

What BBL is and Isn’t Regardless of its very misleading “L”, a BBL is NOT a butt lift. It is a butt augmentation with your own fat. Brazilian Butt Lift (BBL),or gluteal fat grafting, helps women achieve the desired hourglass shape which was traditionally only achievable via restrictive undergarments and corsetry. A large weight loss may result in deflation, significant excess skin above the buttocks and upper thighs with a sagging of the buttock and thighs. This excess skin is removed in a Butt (Thigh) Lift resulting in LIFTING of the buttocks and thighs with a permanent sca. Please see photo on the Right. Moreover, since we are using fat, which has a weight and unlike Helium gas, does not lift and float, when a BBL is performed on already sagging buttocks, we are adding weight to an already sagging structure, resulting in a larger, more sagging buttock (sometimes referred to as (a slipping) diaper booty). Butt Thigh Lift Dr. Aldea Butt Thigh Lift (note the scar) Not every person “needs” a BBL to obtain a defined and sexy butt. In some, (see below and on Liposuction page), Hi-Definition BACK SCOOP Liposuction can achieve a great result without necessarily undergoing a formal BBL. CUSTOMIZED Hi-Definition Liposuction, or BACK SCOOP LIPOSUCTION, could make your buttocks appear much more defined and larger by sculpting and removing the love handles above which misleadingly makes some buttocks appear flat. (All this without necessarily putting fat in the buttocks = cheaper and quicker recovery). High-Definition Liposuction, based on your shape and wishes, will also GREATLY improve and define the appearance of your buttock by nicely narrowing your waist, uncovering the sexy inverted triangle (of Michaelis, aka V Zone) and reducing your WHR (waist to hip ratio) closer to or, under 70% of your hips. (Please, see our BEAUTY page). BUT If you wish a more customized and targeted increase in your buttock volume, your buttocks can then also be FURTHER volumetrically enlarged by transferring some of your own fat into them (i.e. a Brazillian Butt Lift, see below for details). This would greatly enhance both the volume and hemispherical appearance of the buttocks resulting in more youthful, attractive, perky buttocks and a more sensual body profile with a huge boost in self-confidence. Brazilian Butt Lift (BBL) Buttock Augmentation produces long-lasting, full, round, and full buttocks. Moreover, it improves the body’s proportions resulting in a younger appearing, more attractive fit and sensuous, curvaceous figure. Our patients love it and we love to see their transformation! (Click HERE to read a review). WHAT IS Precision Brazilian Butt Lift (PRECISIONBBL®) ? PrecisionBBL® is Ultrasound-guided Fat transfer to the buttocks. It is THE SAFEST way to perform BBLs. Ultrasound guidance assures the precision of buttock fat placement during a Brazilian Butt Lift (BBL). This advanced technology allows Dr. Aldea to place your fat much more accurately and evenly, enhancing the buttocks’ contour and shape. Patients thus enjoy a more tailored outcome, with curves in all the right places. Procedure Appeal – BBL is a two for one or a “twofer”. BBL (Brazilian Butt Lift) holds the promise of a “bubble butt” combined with a ‘snatched’ waist. By taking live fat cells from the areas where it is not wanted, purifying it and then transferring (grafting) it to the buttocks, you get a bigger fuller butt with a more defined waist (the same applies to using your fat to fill the top of the breast and narrow your cleavage. A Twofer). (NOTE – Both Florida and Tennessee have a legal, state imposed, ceiling of fat removal which cannot exceed 4 liters (an estimated 7.9 pounds) of Supernatant fat (the Fat floating in the liposuction collection canister) or, 5 liters of fat including the fluid under the fat (subnatant) fluid. As a result of this regulation liposuction may not always a good choice for large women who require larger fat volume removal). History and Context The Greeks had coined multiple descriptive terms for the buttocks (in Greek - pygē πυγή pi-upsilon-gamma-eta). These include: Callipygy / Callipygian – Having "beautiful" or sexy buttocks. (In addition to their many beautiful works of art depicting the buttocks, a religious Greek cult of buttock worship built a temple for and worshipped Aphrodite Kallipygos (or Aprodite of the Beautiful Buttocks). Callimammapygian - Having beautiful breasts and buttocks, Quatopygia - enticing movement of one's rear end, Planopygian - Having flat buttocks, Pygophily - Men who have a special attraction for female buttocks and Pygoscopia – The observance of someone's backside or, especially, the buttocks.

Each smile. Each pout. Each frown and each squint folds and creases our facial skin. Through the years, as we repeatedly laugh, frown, squint or concentrate, our facial expression muscles contract and wrinkle the overlying skin hundreds of thousands of times. Over time, much like a smooth sheet of paper which has been folded repeatedly (see Right), this results in permanent creasing, wrinkling and aging of our faces. But – it does not have to be this way. Botox® and XEOMIN are GREAT and quick way to ERASE Wrinkles. BOTOX®, XEOMIN and Dysport (Type A Botulinum Toxin, BTX-A) are a natural, safe, highly purified protein derived from the Clostridium botulinum bacteria which has been in medical use close to 30 years. The Botox / XEOMIN / Dysport Treatment Botox, XEOMIN and Dysport therapy is a relatively simple; virtually pain free, 10 minute “lunch time” treatment that will dramatically smooth even your toughest active wrinkles within a few days. No recovery time is needed and most people return to work immediately. Minute amounts of BTX-A (Xeomin, Dysport or Botox) are injected with a tiny needle into the specific points of the muscles causing YOUR wrinkles AFTER the area is fozen with very cold air. The BTX-A (Xeomin, Dysport or Botox) then interferes with the ability of nerve impulses to cause contractions in those specific muscle areas for around 4 months. By relaxing these specific parts of the underlying frowning muscles, BTX-A (Xeomin, Dysport or Botox) smooth active facial lines and wrinkles. A beautifully rested, smooth, wrinkle-free skin above these muscles and a more placid younger look gradually appears within 3-7 days after the injection. Depending on the individual, the smoothing effect can last 4 to 6 months following which the wrinkling muscles slowly regain their strength and reproduce the wrinkles. When the Botox/ Xeomin effect begins to wear off in a few months, the wrinkles are frequently not as deep. If the wrinkle areas are treated repeatedly at regular intervals, the frowning muscles become smaller and the duration of skin smoothness increases prolonging the period between Botox or Xeomin treatments. Botox/Xeomin treatments of wrinkles are especially extremely popular before national holidays, graduations, reunions and summer holidays when families go on vacations. Botox has become the most popular and commonly used cosmetic procedure in the world. What can Botox, XEOMIN or Dysport DO FOR YOU? Botox/XEOMIN and other BTX-A agents are VERY versatile and has been used safely all over the world for years. It is most commonly used to smooth such facial lines and make certain areas of your face look smoother, younger and more refreshed. Although it is FDA approved to smooth “Worry Line” wrinkles in the glabella (base of the nose between the brows), Botox has many other “off label” uses. In the Right, Properly-Trained Hands, Botox and Xeomin can: Smooth horizontal forehead wrinkles (“Frown Lines”) Smooth the “Crow’s feet” wrinkles along the side corners of the eyes Smooth “Bunny Lines”, the ugly wrinkles on the upper bridge of the nose resulting from snarling or scrunching the nose Smooth Vertical Lip lives (“Smokers’ Lines") Lift and arch the Eye Brows (so-called “Chemical Brow Lift”) Lift down turned corners of the mouth, giving a more youthful up turned appearance Correct a “Gummy Smile” by lowering an overly lifted upper lip exposing the upper gum Lift droopy noses associated with smiling Smooth contracted ball like chins Relax and correct prominence of the Masseter (chewing) muscle and reduce pain from tooth grinding Correct the Prominence of Neck Cords or Platysmal Bands (“Turkey Neck”) A combination of several of the items above used in conjunction with wrinkle fillers is also called a LIQUID FACE LIFT Correct and dry up excessive armpit sweating (hyperhydrosis) Non-cosmetic uses of Botox and Xeomin – Botox is also used for non-cosmetic medical conditions. Although we do not treat these purposes in our practice, Botox and Xeomin may also be used to improve blepharospasm (involuntary blinking), overactive bladder, migraine, cluster and tension headaches, lower back pain and neck pain, in spastic disorders, as may be seen after stroke or cerebral palsy and to control spasms of the esophagus (Achalasia, the inability of the lower esophageal sphincter to relax), or vocal cord muscles. It has been also reported to be useful in pelvic muscle spasms, drooling, hair loss, anal fissures and pain from missing limbs (Phantom limb pain). What Could Botox and XEOMIN do for You? If you want to see what YOU may look like with Botox, visit the Allergan BOTOX VISUALIZER page and upload your photo or use your web cam. (Click on the picture on the Right) With the BOTOX® TREATMENT VISUALIZER, you can now picture yourself after treatment with Botox Cosmetic by either uploading YOUR photograph or by using your webcam to photograph you.

As we age, our skin loosens and becomes thinner. But worse yet, the cumulative impact on each of our progressively thinning skins of gravity and a variable exposure to sun radiation, stress, smoking, questionable dietary habits and millions of facial contractions (smiles, frowns, chewing, grimacing, squinting and winking) - all combine to produce a great variety of facial loss of volume, depressions, fine lines and facial wrinkles. While we cannot stop aging, we can stop engaging in certain “pruning” activities and habits which damage and greatly age our skin. Next, to repair this damage we need to restore lost volume to the volume deficient areas. Most skin wrinkles may be smoothed and corrected by the replacement of the lost volume under the wrinkle or depression. This is very effective wrinkle treatment is commonly done by the injection of various soft tissue fillers under the skin depression, nicely lifting it and thereby, greatly smoothing and effacing the wrinkle. Soft tissue fillers are may be used in the a wide variety of skin areas. Although some fillers are better suited than others for each area. As you can see in the diagram on the right, fillers are commonly used in filling facial wrinkles or folds (nasolabial, smoker’s lines, puppet lines, crow’s feet, forehead, neck, chin or base of nose lines), as well as in lip augmentation, in the rejuvenation of thinning hands, and in filling and lifting depressed scars (i.e. acne, or chicken pox). Today’s wrinkle fillers can be classified as either Hyaluronic acid (HA) fillers or NON-Hyaluronic Acid fillers Hyaluronic Acid (HA) Fillers Hyaluronic acid wrinkle fillers have become the most popular fillers in the world. They have far surpassed Collagen, the former leader, in popularity and have practically made the use of Collagen obsolete. Hyaluronic acid (HA) is a natural substance found throughout our body. It gives structure and volume to our skin, lubricates our joints and gives our eyes their shape. Our body's ability to produce hyaluronic acid diminishes with age. As a result, the levels and concentrations of hyaluronic acid concentrations decline with age throughout the human body causing undesirable deflated wrinkly changes in the skin. Returning HA to the skin restore its volume and appearance and makes the skin appear youthful again. Areas where Wrinkle fillers are used The two most commonly used hyaluronic acid fillers in the world are: 1. Restylane®and Perlane®produced by Q-Med and distributed in the US by Medicis. (Please, click HERE to learn more about Restylane and Perlane and see what they can do for YOU) and 2. Juvēderm – produced by Allergan (Please, click HERE to learn more about Juvēderm and see what it can do for YOU) NON-Hyaluronic Acid (HA) Fillers Fat Grafting - Your own fat can be borrowed from other areas of your body and used to smooth wrinkles, folds or depressions anywhere in your body such as wrinkles at the corners of the mouth ("puppet" lines or "drool grooves"), cheek/smile (nasolabial) lines or other skin depressions (i.e. acne scars) and to smooth and rejuvenate aging hands (where the tendons, veins and bones become too prominent). The injected fat fills the defect, lifts the depression and flattens the overlying wrinkles and folds. Fat may be suctioned under local anesthesia from your lower abdomen, lateral or inner thighs or buttocks and placed in the skin under the fold or depression. The procedure may be done by itself or may be combined with liposuction of other areas of the body. Most patients return to work in 5-7 days and are able to assume more strenuous activities in 7-14 days. The IDEAL Wrinkle Filler By their nature, plastic surgeons are curious and artistic individuals who are always looking for newer, better and safer ways to improve their patients’ lives. Plastic surgeons have long looked for THE ideal soft tissue filler; Such a filler would have to combine great ease of use, no downtime for the patient (walk-in, put in, walk-out), have immediate predictable and durable results and it would not be associated with any allergic reactions, infection, inflammation or disease. Unfortunately, no one single filler available today combines all of these desirable qualities but some have more of these desirable characteristics than others. The field of soft tissue augmentation is in constantly changing. We continuously see new fillers appear with great fanfare and mass media advertising only to see them slowly retreat to a more realistic position or to be taken off the market once their limitations become known to plastic surgeons.

The fascination of both sexes with the female breast and the desire by women to have fuller breasts predates the writing of the Bible. Dating back to antiquity, the written records, paintings and sculptures of many cultures have idolized the shapely breast. This universal breast fascination has continued despite the introduction of breast and body revealing clothes and our ever increasing media-driven familiarity with the female breast. Youthful full breasts have always defined femininity. But the pressure on women to have or, at least, present fuller chests began just before WWII, when movies, glamour magazines and advertisements, began to repeatedly featuring full-chested actresses and models. However, it was not until the early 1960’s that Plastic Surgery begun having the capability to correct this particular shortcoming of nature. The history of breast augmentation surgery is VERY interesting. (You can more of it on our HISTORY page). Breast enlargement is a great operation. In most cases, it improves the appearance of the breasts and does away with the insecurity and self-doubt that women with smaller breasts commonly have. In the past 30 years, nearly two million American women had undergone breast augmentation and the vast majority is very happy with their decision and would do it again. Breast enlargement surgery is the commonest cosmetic surgery procedure in Memphis and the Mid-South. Small or mildly sagging breasts can be made perkier and larger by placement of breast implants. Breast implants consist of a silicone elastomer shell which is filled either with saline (sterile salt water commonly used for IV fluids) or with viscous gelatinous silicone gel. (see Mentor MemoryGelTM). There are many different types of breast implants. In general, breast implants are classified based on their filler (saline vs. silicone), their shape (round vs. teardrop (i.e. anatomical or contoured)), their profile projection (low, moderate, moderate plus or high) and by the texture of their surface (smooth vs. textured). You will have to decide on: • Access Incision placement - (around areola (Periareolar), Breast fold (Inframammary), arm pit crease (Transaxillary) • Implant Placement - Above pectoralis muscle vs. Under the muscle) • Implant Filler (saline vs. silicone) • Implant Shape (round vs. anatomical) • Implant Surface Texture (smooth vs. textured) • Implant Profile projection (low, moderate, moderate plus or high) and, • Implant Volume / Weight (cc's) In your consultation, Dr. Aldea and Dr. Eby will then help you through this maze of choices to choose the breast implant that is best for you based on your chest width, chest slope, breast cover and your desired breast size There are many options in breast augmentation without a single "best choice" which is universally applicable to all women. Each choice has its own advantages and trade-offs. Since each woman possess a unique combination of anatomy and long-term goals, Dr. Aldea and Dr. Eby strongly believe that to achieve success in breast augmentation, the procedure should be individualized and customized to each individual woman's circumstances rather than using a "one operation fits all" approach. The key to a successful breast enlargement surgery is knowing your options and making a series of educated choices. After fully understanding all your options, you will arrive at your “best” implant/incision/placement choice. ACCESS INCISIONS AND IMPLANT PLACEMENTS Breast implants are commonly placed through a small incision either around the nipple complex (periareolar), under the breast fold (inframammary), or through the armpit (trans-axillary). Some surgeons use the navel (TUBA) to place their breasts implants. Each incision has its advantages and Dr. Aldea and Dr. Eby will educate you as to which may best suit your goals. The breast implants may be placed either under the breast gland and over the pectoralis major muscle (center Right), or under the pectoralis muscle (far Right). The plastic surgeon then creates a pocket, either directly behind the breast tissue or underneath your chest wall muscle. Implant placement behind the muscle (retro-pectoral) may interfere less with mammograms than if the implant is placed directly behind the breast tissue The choice of incision and site of implant placement depends on the patient’s goals and expectations.

As everyone knows, pregnancy profoundly changes women?s bodies. The unmatched joy associated with having children is unfortunately frequently also associated with unwanted changes in women?s figures which cause embarrassment and self-consciousness. While the vast majority of women cherish their children, most would love to regain their pre-pregnancy appearances. Pregnancy and breast feeding often result in a large variety and many combinations of unwelcome body deformities. Different combinations and severities of sagging and or deflated breasts, flabby, loose tummies, stubborn pockets of fat on the hips and thighs and sagging buttocks are seen in each woman. Since each pregnancy brings about specific, individual changes in each woman, there is no single solution which is uniformly successfully applicable to all women. To achieve success, each woman requires an individualized approach by her Plastic surgeon to define and to reverse her particular unwanted post-pregnancy anatomical changes. Depending on your presenting problem(s) and your concerns and desires, one or several cosmetic surgery procedures (i.e. breast enlargement, breast lift, tummy tuck, thigh/buttock lift or liposuction) may be needed to restore and reclaim your body. The beauty of the "Mommy Makeover" is that in consultation with Dr. Aldea or Dr. Eby, you will choose which cosmetic surgery procedure(s) is right for you. ABDOMEN - Do you have the dreaded ?Mommy Tummy?, ?Bulge? or ?Pooch?? - Do you find yourself pinching your midsection or sides in the mirror wishing you could just pinch it off painlessly and flatten your tummy? - Do you find yourself frequently ?sucking it in? in social situations and hate having your picture taken from the side? You are not alone. Every mother had, has and will have a variable manifestation of this very common anatomical post-pregnancy phenomenon. Before discussing potential solutions, it is important that you really understand what pregnancy (or intra-abdominal obesity) does to your abdominal wall. The normal anatomy of the abdominal wall consists of two paired vertically straight (rectus) muscles, the Rectus Abdominis (aka Six Pack) muscles, in the midline which are attached to one another with a white, dense ligament - the Linea Alba. On the sides, the abdominal wall resembles a radial tire with 3 muscles stacked on each other with their fibers running at right angles to the muscle fibers above or below it; The External Oblique, Int. Oblique and Transversus Abdominis muscles. As a result of this tight construction, weaknesses and hernias are very uncommon along the sides of the abdomen. In addition to stretching the skin, the growing baby also stretches and causes a permanent separation between the rectus muscles - a Diastasis Recti. The extent of this muscle separation depends on many factors, including your genetic or familiar predisposition, your ethnicity and skin’s type and its elasticity, the rate of growth and the ultimate size of your baby (ies), your size and physical conditioning and the number of your pregnancies. Do you have a Tummy Muscle Separation (Diastasis recti)? If you think you do, you probably have one. But, to be sure do the following: 1. Face sideways to a long mirror and bend fully at the waist with your arms extended forward as if diving off the side of a pool. Now, RELAX your tummy completely. (It is not easy and may take a few seconds). Slowly look sideways. Do you have a positive “Hammock Sign”? 2. Lie on your back on the floor with your knees bent and put your hand flat with your fingers on the midline just under your belly button. Then, as you lift your head off the floor, push with your fingertips and feel for a wide gap (THE diastasis) between the two rectus muscles. Such gaps usually extend upwards past the belly button. (Sometimes the separation is wide enough to allow you the feel the pulsations of your abdominal aorta, the biggest artery in the body, on the back wall of the abdomen). The BAD News - Although most pregnancies are followed by some excess skin shrinkage and exercise may produces a very mild improvement, the muscle separation (rectus diastasis) is a permanent structural and physical separation. As such, despite much of the hype out there, it cannot be reversed by diet and exercise. Although exercise may improve it slightly, it will never flatten the tummy to the way it was prior to your pregnancy(ies).

Facelift or rhytidectomy is typically performed to remove loose or sagging skin from the face and neck. The goal of the facelift operation is to achieve a more rested and youthful appearance of the face. As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and corners of the mouth; the jaw line grows slack and jowls form and become pronounced; folds and fat deposits appear around the neck. A facelift can "set back the clock," improving the most visible signs of aging by removing excess fat, tightening under-lying muscles, and re-draping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a foreheadlift (to pick sagging brows and smooth a creasing forehead), eyelid surgery, or nose reshaping. Through an incision which begins in the hair near the temple, continues in front of the ear, around the ear lobe, behind the ear and into the hair, the skin is separated from the underlying tissue. The underlying sagging tissue is then tightened, facial skin is re-draped, the excess skin is removed and a smoother appearance is achieved. If you have loose skin and excess tissue under your chin, this may be addressed in the same procedure. The procedure is usually done as an outpatient procedure either under local anesthesia with sedation or under general anesthesia. Depending on the extent of skin laxity and any other combined procedures, the operation may take several hours. Minimal facelifts can be performed quickly and with little risk, but the degree of correction achieved by these lifts is also less. More extensive techniques can give better correction of the aging changes in the face, but at the cost of greater operating time, more risk, longer swelling, slower recovery, and greater cost. The operation may be associated with temporary bruising, swelling, numbness, tenderness and skin tightness. Some of the complications associated with this procedure are infection, bleeding from the cut tissues, leading to bruising and possible accumulations of blood under the skin, poor healing with wound separation (especially in smokers), raised scars, asymmetry, either temporary or permanent injury to one or more of the nerve branches which control the muscles of facial expression. Patients usually feel and look better surprisingly quickly after a facelift. Despite the fact that it is a large operation, there is usually very little pain. Swelling disappears within a few days, and bruises are usually gone by two weeks, as are the stitches. Patients generally feel a sense of tightness and numbness that should gradually return to normal within several weeks. To improve healing you will need to wear an elastic supportive garment briefly after the procedure and should limit exposure to sun for several months. Many patients are able to return back to work in two weeks and to resume more strenuous activities in 3 to 4 weeks. Contrary to popular opinion, a face lift will not give someone beautiful skin unless they have beautiful skin to begin with. It is important to understand that while a face lift will tighten the skin, it will not change the texture of the skin. As a result any pre-existing acne scars, age spots, fine lines and "smokers' creases" will soon return to their original texture, no matter how tight the skin is pulled. Only chemical peels or other skin treatments can change the nature of the skin. After recovery, patients can expect a more rested and often youthful appearance. Although a facelift can improve the appearance, time marches onward. The skin continues to age and gravity begins to pull the skin down immediately upon completion of the surgery. Although a face lift can last for many years, patients continue to age, therefore, it is impossible to predict how long it might be before an individual would consider a second lift. As regards the current cost of Facelift, our fees are extremely competitive, not only within our own metropolitan Memphis area, but also in comparison with fees charged elsewhere in the United States. Can a Facelift answer your particular needs ? If you would like to learn more about it and see what it can do for you, please, call (901) 752-1412 to schedule your consultation.

As a woman, Dr. Eby brings superb knowledge, experience and unmatched sensitivity to other women’s concerns. Dr. Aldea and Dr. Eby are Memphis’ labiaplasty experts. They will listen to your concerns and then customize your vaginal rejuvenation, Labiaplasty, Labial Puffing, Labial Reduction, Clitoral Hood Reduction or Monsplasty to your individual needs. Dr. Aldea and Dr. Eby can reduce the length of the inner lips so they no longer twist and relieve the pain of the lips being tugged. And they can fill your outer lips (Labial Puffing) with either Radiesse or your own fat, if needed, to create a nicer symmetrical appearance and restore your confidence and self-esteem. ANATOMY - Many people are unfamiliar with the anatomy and terminology of the female genitals and mistakenly call the entire outside area of women’s genitals “the vagina”. But the external part, including the labia, is the vulva. A short review will make understanding the topic much easier. These are the anatomical terms you need to understand: VULVA - refers to the WHOLE external woman’s genitals. It has 4 sub-components: 1. MONS PUBIS (MONS Veneris) - is the hairy, fatty mound over the pubic bone. 2. Two sets of skin folds, or LIPS (labia) A- smaller INNER Lips (Labia Minora) are two small cutaneous folds extend from the clitoris superiorly to the fourchette inferiorly. The Labia Minora protect the vagina and provide sensation during sex (Note-their size has nothing with either the number of your sexual partners or how often you had sex). B- wider, fuller, hair bairing OUTER Lips (Labia Majora) 3. GLANS CLITORIS - the round and very sensitive area of the vulva whose only purpose is sexual arousal. It is covered by a skin extension of the labia minora called the clitoral hood or prepuce. 4. VAGINA (or the birth canal) - is the tube between the cervix portion of the uterus and the outside. Most of the vagina is internal. The vaginal opening (or introitus) is its only externally visible portion. (Note-Neither birth or frequent sex can permanently "stretch" your vagina through vigorous sex) 5. Urethral opening - the opening where you urinate from. Are my Labia Attractive? Without engaging in “everyone-is-beautiful-in-their-own-way” debates, it is very clear that many women and men have long prefered thin, symmetrical curves to thick and asymmetric curves. From the lines of the gothic arch windows, to the streamlined car designs of the 1920’s to today’s women’s magazines, TV; It is all around us. The painter Georgia O'Keefe (1887-1986), best known for her paintings of flowers, skulls, and desert landscapes, is thought to have painted vaginas metaphorical disguised as flowers. She often painted them with very short, thin inner labia that don't protrude, with a small, visible clitoris. Georgia O'Keefe is sometimes used as slang for vaginal lips. Understandably, as the majority of women began routinely shaving, wearing sheer, tight underwear and more frequently began seeing both their privates as well as other women’s privates, Dr. Patricia Eby Top Doctor Plastic Surgery similar accepted and desired genital “beauty standards” or goals began emerging. As more women began routinely shaving, wearing sheer, tight underwear and increasingly began seeing their privates as well as other women’s privates in films and the gym, certain accepted and desired genital “beauty preferences” or goals began emerging. Is there a “Perfect Vagina”? With this increasing exposure and comparison, many women and men developed a preference for the “ideal” youthful genital look of a largely flat mons, mostly concealed symmetrical, short labia minora and defined, full, smooth labia majora with visibility of the clitoris. This “look” is not for everyone but it is the most popular and requested appearance. (Taken to an extreme we have the porn “Barbie look” vagina where the inner lips are either very small, missing or erased with airbrushing) Sadly, departure from these perceived ideals of the privates led to insensitive descriptive terms like camel toe, meat curtains, beef curtains, corn beef curtains, meat wings, meat flaps, ham sandwich, lady giganta, rooster head, velvet buzzsaw, hang and more to describe unattractive female genitalia (If you are interested, please, consult the The Urban Thesaurus for hundreds of more similar terms).

Gynecomastia is Very Common Gynecomastia (“Man Boobs”) is extremely common and affects an estimated 40 to 60 percent of all men – rich, famous and ordinary alike. As you can see below, many Hollywood stars, Senator Kennedy as well as several world leaders such as Russian President Vladimir Putin and former British PM Tony Blair appear to have gynecomastia. WHY do Boys and Men Develop Breasts? Men and women produce both male (testosterone) and female (estrogens) hormones. Our breasts are very sensitive to the balance and ratio between estrogen and testosterone levels in our blood. If there is either a fall in the testosterone level and, or a rise in the estrogen level, breasts are stimulated to grow. The ratio of male to female hormone in our bodies may be reduced by obesity, old age, taking certain drugs or medications that simulate female hormones and by certain diseases. Gynecomastia has many potential causes. Male breast over-development may be divided into two large groups: Physiologic or normal gynecomastia and Pathologic (or Abnormal) gynecomastia. Normal (Physiologic) Gynecomastia affects up to 60% of men at some point in their lives. It is commonly seen with newborn boys (due to maternal circulating estrogens) and may last for a few weeks, as well as in obese boys and men and in older men. Normal Gynecomastia has two large peaks. The first peak begins and most often ends during the teen years. (Its incidence rises from about 2% of 11-years-old boys to a peak of about 60% of 15-year-olds and then falls to around 20% per cent of 17-year-old boys). This common occurrence of Physiologic gynecomastia in puberty may be related to transient rise in female hormones with a rise in the ratio of female-to-male hormones. At puberty, the testosterone level does not rise steadily. Over the first few teenage years, it continually fluctuates wildly. These dips in testosterone allow the small amount of estrogen (female hormone) in the circulation to stimulate the breasts resulting in enlarging and/or tender breasts. As a higher level of testosterone is produced inthe latter teen years, breast growth regresses and most affected boys outgrow it. The second peak occurs in around the age of 60, when gynecomastia rises slowly and affects over 40% of healthy aging men. Fat cells preferentially produce more female hormones. As a result, male obesity is commonly associated with breast development. In addition, aging is often associated with some degree of gynecomastia. A combination of decreased production of testosterone with an increased amount of body fat (which produces estrogens) cause breast stimulation and growth. Gynecomastia is also seen in men who lost weight. Many of them often come to our office with residual stubborn pockets of fat on their chests despite working out in the gym all the time. Pathologic Gynecomastia is caused by one or a combination of three processes : 1) Deficiency in Testosterone production or action (including androgen receptor defects) with or without a related increase in Estrogen production, 2) Increase in Estrogen production and, or Hypersensitivity of Breast tissue to Estrogens 3) In 10-20% of cases, man breasts may be also seen with long term use of certain medications, including taking either body-building steroids or estrogens, taking some drugs which have an estrogen-like effect on the breast or others which act by blocking the effect of testosterone. The body always strives for balance. When it senses a higher level of The body always strives for balance. When it senses a higher level of testosterone or testosterone-like compounds, it will actively change them, by a process called aromatization, into an estrogen like hormone. As a result, the intake of such anabolic steroids (especially, Anadrol, Dianabol and Sustanon) is associated with rapid development of men breasts. The prolonged use of certain tricyclic antidepressants or valium, of certain Calcium-channel blockers (anti-hypertension or heart problems medications) (such as nifedipine, verapamil, diltiazem), ACE inhibitors (such as captopril, enalapril), Digoxin, Amiodarone or, Spironolactone, such as Drugs for duodenal ulcer (i.e. Omeprazole, Ranitidine, Cimetidine, Zantac or Tagamet), certain Antibiotics and antifungal drugs (i.e. Isoniazid, Metronidazole (Flagyl) or Ketoconazole) , Proscar and Propecia are associated with gynecomastia. Some of the anti-AIDS drugs known as Retroviral Therapies are associated with gynecomastia. In addition, the abuse of alcohol and the use of illegal drugs such Marijuana, Heroin, methadone or Amphetamines result in breast development. Although stopping these medications may lead to regression of the gynecomastia, in some cases, surgery may still be needed to eliminate the condition.